IIEF Questionnaire

IIEF: International Index of Erectile Function Questionnaire

Please use an X where applicable and be sure to initial and date all corrections

Score 0 if not done_______________ Subject questionnaire Section 1

Instructions: These questions ask about the effects your erection problems have had on your sex life, over the past 4 weeks. Please answer the following questions as honestly and clearly as possible. In answering these questions, the following definitions apply:

Sexual intercourse is defined as vaginal penetration of the partner (you entered the partner)

Sexual stimulation includes situations like foreplay with a partner, looking at erotic pictures, etc.

Ejaculate is defined as the ejection of semen from the penis (or the feeling of this)

Mark ONLY one circle per question:

1. Over the past 4 weeks, how often were you able to get an erection during sexual activity?

0 No sexual activity 0 Almost always or always 0 Most times (much more than half the time) 0 Sometimes (about half the time) 0 A few times (much less than half the time) 0 Almost never or never

2. Over the past 4 weeks, when you had erections with sexual stimulation, how often were your erections hard enough for penetration?

0 No sexual stimulation 0 Almost always or always 0 Most times (much more than half the time) 0 Sometimes (about half the time) 0 A few times (much less than half the time) 0 Almost never or never

Questions 3, 4 and 5 will ask about erections you may have had during sexual intercourse.

3. Over the past 4 weeks, when you attempted sexual intercourse, how often were you able to penetrate (enter) your partner?

0 Did not attempt intercourse 0 Almost always or always 0 Most times (much more than half the time) 0 Sometimes (about half the time) 0 A few times (much less than half the time) 0 Almost never or never

4. Over the past 4 weeks, during sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?

0 Did not attempt intercourse0 Almost always or always0 Most times (much more than half the time)0 Sometimes (about half the time)0 A few times (much less than half the time)0 Almost never or never

5. Over the past 4 weeks, during sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?

0 Did not attempt intercourse 0 Almost always or always 0 Most times (much more than half the time) 0 Sometimes (about half the time) 0 A few times (much less than half the time) 0 Almost never or never

6. Over the past 4 weeks, how many times have you attempted sexual intercourse?

7. Over the past 4 weeks, when you attempted sexual intercourse how often was it satisfactory for you?

0 Did not attempt intercourse 0 Almost always or always 0 Most times (much more than half the time) 0 Sometimes (about half the time) 0 A few times (much less than half the time) 0 Almost never or never

8. Over the past 4 weeks, how much have you enjoyed sexual intercourse?

9. Over the past 4 weeks, when you had sexual stimulation or intercourse how often did you ejaculate?

0 Did not attempt intercourse 0 Almost always or always 0 Most times (more than half the time) 0 Sometimes (about half the time) 0 A few times (much less than half the time) 0 Almost never or never

10. Over the past 4 weeks, when you had sexual stimulation or intercourse how often did you have the feeling of orgasm or climax (with or without ejaculation)?

0 No sexual stimulation or intercourse0 Almost always or always0 Most times (much more than half the time)0 Sometimes (about half the time)0 A few times (much less than half the time)0 Almost never or never

Questions 11 and 12 ask about sexual desire. Let's define sexual desire as a feeling that may include wanting to have a sexual experience (for example, masturbation or intercourse), thinking about having sex or feeling frustrated due to a lack of sex.

11. Over the past 4 weeks, how often have you felt sexual desire?

0 Almost always or always 0 Most times (much more than half the time) 0 Sometimes (about half the time) 0 A few times (much less than half the time) 0 Almost never or never

12. Over the past 4 weeks, how would you rate your level of sexual desire?

0 Very high 0 High 0 Moderate 0 Low 0 Very low or none at all

13. Over the past 4 weeks, how satisfied have you been with you overall sex life?

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